The lower prevalence among young women is associated with an increased likelihood of using condoms — particularly with casual partners. However, data from BAIS II suggest that many Batswana still hold mistaken beliefs about HIV. For example, 30% believe that AIDS can be acquired by supernatural means (such as a curse), and over 50% think it can be acquired by mosquito bites.
Very few Batswana are aware that having multiple sexual partnerships is associated with a much higher risk of HIV (~21%). This is troubling considering that many Batswana have multiple partnerships. According to Dr. Molly Smit of BOTUSA (a partnership between the US CDC and Botswana), most of the households are headed by women, and “each child has a different father.”
When opening the conference, Dr. Kgosi Mompati, President of the Botswana Branch of the Southern Africa HIV Clinicians Society, said that there is a persistent carelessness around sex.
He conducted focus groups examining sexual attitudes among Batswana youth two years ago and was struck by language that seemed “aimed at getting youth to abandon the use of condoms” and engage in multiple partnerships.
For example, “among men,” Dr. Mompati said: “ ‘jumping out of the plane without a parachute’ means having sex without a condom, and when you do that you are a brave man and many others must follow you. ‘First in command’ is the wife with an unfaithful husband, and everything must be kept secret, and among them there is no condom use. Second in command is the stable girlfriend, well supported by a married man. Short range: Casual female sex partner met in night clubs and sex without condom. Handing over, means recommending your casual sex partner to a friend, giving him liberty to sleep with her and often without a condom.
“It's not just carelessness among men, there’s also carelessness among women. This language “I feel you” is what a girl will say to a boy indicating she wants to have sex with him without any commitment whatsoever and often without a condom.”
Professor Tlou pointed out there are gender-related age discrepancies in HIV serostatus, with many HIV-infected young women but few HIV-infected young men. However, with increasing age, there is increasing parity between men and women. She believes this may be evidence of intergenerational sex.
According to Dr. Mompati, there is often a transactional nature to these relationships. In his focus groups, young women gave these “clients” titles.
“The ‘Minister of Education’ is the client of a girl who buys books and stationery; the ‘minister of telecommunications’ is the man who is responsible for buying her mobile phone and airtime, the ‘minister of commerce’ buys clothes and the ‘minister of transport’ provides taxi fares. These honourable ministers do not use condoms because they pay more,” he said.
Information, education and communication (IEC) programmes in Botswana are increasingly trying to tackle intergenerational sex and promote fidelity. “I think it is an issue we need to confront to a larger extent than we have so far, by targeted interventions for both men and the youth,” she wrote in the Technical Report’s preface. However, she also alluded to a quote recently made by President Mogae.
“We have reached a crossroads in which there is a genuine opportunity to begin to move toward significant and sustainable reduction in new infections, but people will first have to embrace this prospect in their own lives.”